title: Role of complement factor H I62V and age-related maculopathy susceptibility 2 A69S variants in the clinical expression of polypoidal choroidal vasculopathy.
abstract: OBJECTIVE
  To investigate the role of complement factor H (CFH) I62V (rs800292) and age-related maculopathy susceptibility 2 (ARMS2) A69S (rs10490924) variants in the clinical characteristics of polypoidal choroidal vasculopathy (PCV).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  A total of 226 Japanese patients with PCV in both eyes (44 cases) or in 1 eye (182 cases).
  
  
  METHODS
  Genotyping was performed in all cases for CFH I62V using TaqMan technology and for ARMS2 A69S by denaturing high-performance chromatography. The incidence of 5 characteristic funduscopic findings was studied, including serous retinal detachment, subretinal hemorrhage, serous pigment epithelial detachment (PED), hemorrhagic PED, and classic choroidal neovascularization (CNV).
  
  
  METHODS
  The association of clinical phenotypes, including the incidence of each of 5 specific fundus findings, bilaterality of the disease, and age at onset, with variants of CFH I62V or ARMS2 A69S.
  
  
  RESULTS
  Although there was no association of CFH I62V variants with any of the phenotypes in PCV, at-risk variants of ARMS2 A69S were associated with higher incidences of subretinal hemorrhage, serous PED, and hemorrhagic PED. In particular, the at-risk allele homozygosity of ARMS2 A69S increased the likelihood for hemorrhagic PED by 12.4-fold compared with non-carriers of the allele (confidence interval, 1.60-95.1, P = 0.0001). However, the at-risk allele of ARMS2 A69S was associated with a lower incidence of serous retinal detachment (P = 0.0092). Classic CNV was not associated with either variant. The mean age at the onset of PCV was significantly younger (68.8 years) in those with homozygosity of the at-risk allele of ARMS2 A69S than in those with heterozygosity (71.6 years) or in non-carriers (72.6 years) (P = 0.026). Moreover, the at-risk allele frequencies of the ARMS2 A69S were significantly higher in bilateral cases than in unilateral cases (75.0% vs. 59.3%, P = 0.007).
  
  
  CONCLUSIONS
  ARMS2 A69S variants were significantly associated with hemorrhagic or subpigment epithelium lesions of PCV, and with earlier onset and bilateral involvement. The genotyping of ARMS2 A69S is more informative than that of CFH I62V in understanding the clinical features in patients with PCV.
authors.affiliation: Department of Ophthalmology, University of Yamanashi, Yamanashi, Japan. sakurada@yamanashi.ac.jp
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Sakurada
authors.forename: Takeo
authors.initials: T
authors.lastname: Kubota
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Imasawa
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Mabuchi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Tateno
authors.forename: Naohiko
authors.initials: N
authors.lastname: Tanabe
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Iijima
mesh_terms: D000328:Adult; D017668:Age of Onset; D000409:Alanine; D002829:Choroid / Q000098:blood supply*; D015862:Choroid Diseases / Q000235:genetics*; D020256:Choroidal Neovascularization / Q000453:epidemiology / Q000235:genetics; D002845:Chromatography / Q000379:methods; D017242:Complement Factor H / Q000235:genetics*; D003430:Cross-Sectional Studies; D005654:Fundus Oculi; D005787:Gene Frequency; D014644:Genetic Variation; D005838:Genotype; D006579:Heterozygote; D006720:Homozygote; D006801:Humans; D015994:Incidence; D007532:Isoleucine; D010641:Phenotype; D011127:Polyps / Q000235:genetics*; D011506:Proteins / Q000235:genetics*; D012163:Retinal Detachment / Q000453:epidemiology / Q000235:genetics; D012166:Retinal Hemorrhage / Q000453:epidemiology / Q000235:genetics; D055213:Retinal Pigment Epithelium / Q000473:pathology; D012694:Serine; D014633:Valine; D014652:Vascular Diseases / Q000453:epidemiology / Q000235:genetics*
chemical_list: C514392:ARMS2 protein, human; D011506:Proteins; D007532:Isoleucine; D012694:Serine; D017242:Complement Factor H; D014633:Valine; D000409:Alanine